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Vol. 3. Issue 1.
Pages 13-18 (January - March 2010)
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Vol. 3. Issue 1.
Pages 13-18 (January - March 2010)
DOI: 10.1016/S2173-5050(10)70003-0
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Quality of the written information about suicide attempters
Calidad de los informes médicos sobre personas que han intentado suicidarse
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Marta Mireta,b, Roberto Nuevoa,b, Consuelo Morantc, Enrique Sainz-Cortónd, Miguel Ángel Jiménez-Arrierob,e, Juan J. López-Iborb,f, Blanca Renesesb,f, Jerónimo Saiz-Ruizb,g, Enrique Baca-Garcíab,h,i, José Luis Ayuso-Mateosa,b,
Corresponding author
joseluis.ayuso@uam.es

Corresponding author.
a Departamento de Psiquiatría, Universidad Autónoma de Madrid, Hospital Universitario de la Princesa, Madrid, Spain
b Instituto de Salud Carlos III, Centro de Investigación en Red de Salud Mental, CIBERSAM, Spain
c Oficina Regional de Salud Mental, Comunidad de Madrid, Spain
d Departamento de Psiquiatría, Hospital Universitario Gregorio Marañón, Madrid, Spain
e Departamento de Psiquiatría, Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, Spain
f Instituto de Psiquiatría y Salud Mental, Hospital Universitario Clínico San Carlos, Universidad Complutense, Madrid, Spain
g Departamento de Psiquiatría, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain
h Departamento de Psiquiatría, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Spain
i Departamento de Psiquiatría, Columbia University, Nueva York, USA
Article information
Abstract
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Abstract
Introduction

The aim of the study was to assess the quality of the clinical records of the patients who are seen in public hospitals in Madrid after a suicide attempt in a blind observation.

Methods

Observational, descriptive cross-sectional study conducted at four general public hospitals in Madrid (Spain). Analyses of the presence of seven indicators of information quality (previous psychiatric treatment, recent suicidal ideation, recent suicide planning behaviour, medical lethality of suicide attempt, previous suicide attempts, attitude towards the attempt, and social or family support) in 993 clinical records of 907 patients (64.5% women), ages ranging from 6 to 92 years (mean 37.1±15), admitted to hospital after a suicide attempt or who committed an attempt whilst in hospital.

Results

Of patients who attempted suicide, 94.9% received a psychosocial assessment. All seven indicators were documented in 22.5% of the records, whilst 23.6% recorded four or less than four indicators. Previous suicide attempts and medical lethality of current attempt were the indicators most often missed in the records. The study found no difference between the records of men and women (z=0.296; p=0.767, two tailed Mann-Whitney U test), although clinical records of patients discharged after an emergency unit intervention were more incomplete than the ones from hospitalised patients (z=2.731; p = 0.006), and clinical records of repeaters were also more incomplete than the ones from non-repeaters (z=3.511; p<0.001).

Conclusions

Clinical records of patients who have attempted suicide are not complete. The use of semi-structured screening instruments may improve the evaluation of patients who have self- harmed.

Keywords:
Deliberate self-harm
Emergency service
Suicide
Resumen
Introducción

El objetivo de este estudio fue evaluar, mediante una observación ciega, la calidad de los informes clínicos de los pacientes vistos en hospitales públicos de Madrid tras un intento de suicidio.

Método

Estudio observacional, descriptivo transversal llevado a cabo en cuatro hospitales generales públicos de Madrid (España). Se analizaron siete indicadores de calidad (antecedentes de atención psiquiátrica, intentos de suicidio previos, apoyo social o familiar, ideación suicida, planificación suicida, reacción frente al intento y grado de daño médico como resultado del intento actual), en 993 informes clínicos de 907 pacientes (el 64,5%, mujeres), con edades comprendidas entre los 6 y los 92 (media, 37,1±15) años, que acudieron al hospital tras un intento de suicidio o que lo intentaron cuando estaban en el hospital.

Resultados

De los pacientes que intentaron suicidarse, el 94,9% recibió una evaluación psicosocial. Los siete indicadores se documentaron en el 22,5% de los informes, mientras que en el 23,6% se registraron cuatro indicadores o menos. Los intentos de suicidio previos y la letalidad del intento actual fueron los indicadores que con mayor frecuencia faltaban en los informes. No aparecieron diferencias entre los informes de los varones y los de las mujeres (z=0,296; p=0,767, prueba de la U de Mann-Whitney bilateral), aunque los informes de los pacientes dados de alta tras la atención en urgencias estaban más incompletos que los de los pacientes ingresados (z=2,731; p=0,006), y los informes de las personas con intentos previos también estaban más incompletos que los de aquellos que no tenían intentos previos (z=3,511; p<0,001).

Conclusiones

Los informes clínicos de las personas que han intentado suicidarse no están completos. El uso de instrumentos de evaluación semiestructurados puede mejorar la evaluación de los pacientes que se han autolesionado.

Palabras clave:
Autolesión deliberada
Servicios de urgencia
Suicidio
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